Comparison of Total Hip Replacement and Hemiarthorplasty in the Treatment of Femoral Neck Fractures in Elderly Patients

LIU Heng; SUN Yiyan; FENG Hui; GAO Yunlong; CAI Xiaosong; WEN Lei; ZHAO Ben; ZHU Xuekun

doi:10.14033/j.cnki.cfmr.2024.30.020

Abstract：Objective:To investigate the effect of total hip replacement and hemiarthroplasty in the treatment of senile femoral neck fracture. Method:A total of 100 elderly patients with femoral neck fracture treated in the 71st Army Hospital from May 2020 to May 2023 were selected as the study objects and divided into comparison group and observation group according to the surgical method,with 50 cases in each group. Hemiarthroplasty was performed in the observation group,and total hip replacement was performed in the observation group. The results before and after hip functional operation,complication rate,operation and hemorheology indexes were compared between the two groups. Result:6 months after surgery,the Harris score of hip joint in both groups decreased,and the above score in the observation group was lower than that in the comparison group,the difference was statistically significant (P<0.05). The excellent and good rate of hip joint function in observation group was higher than that in comparison group,and the difference was statistically significant (P<0.05). The incidence of complications represented by acetabular wear,acetabular hyperplasia,hip swelling on the affected side and prosthesis loosening in the observation group were lower those that in the comparison group,with statistical significance (P<0.05). The intraoperative blood loss and postoperative drainage volume in the observation group were higher than those in the comparison group,and the difference was statistically significant (P<0.05). The operation time and hospital stay in the observation group were longer than those in the comparison group,and the difference was statistically significant (P<0.05). There was no significant difference in comparison of whole blood high tangential viscosity (HBV),whole blood low tangential viscosity (LBV) and plasma viscosity (PV) between the two groups before surgery and 0.5 months after surgery (P>0.05). 0.5 months after operation,HBV,LBV and PV increased in both groups,and the differenceswas statisically significant. Conclusion:Total hip replacement and hemiarthroplasty are performed in elderly patients with femoral neck fractures. The former has better surgical effect,is more beneficial to postoperative hip functional recovery of patients,can reduce the incidence of complications such as acetabulum wear and hyperplasia,ensure the integrity of the acetabulum,and improve hemorheology indexes.